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Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study
OBJECTIVE: To describe 20-year risk factor trajectories according to initial weight/health status and investigate the extent to which baseline differences explain greater mortality among metabolically healthy obese (MHO) individuals than healthy non-obese individuals. METHODS: The sample comprised 6...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6268092/ https://www.ncbi.nlm.nih.gov/pubmed/30108269 http://dx.doi.org/10.1038/s41366-018-0192-0 |
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author | Johnson, William Bell, Joshua A. Robson, Ellie Norris, Tom Kivimäki, Mika Hamer, Mark |
author_facet | Johnson, William Bell, Joshua A. Robson, Ellie Norris, Tom Kivimäki, Mika Hamer, Mark |
author_sort | Johnson, William |
collection | PubMed |
description | OBJECTIVE: To describe 20-year risk factor trajectories according to initial weight/health status and investigate the extent to which baseline differences explain greater mortality among metabolically healthy obese (MHO) individuals than healthy non-obese individuals. METHODS: The sample comprised 6529 participants in the Whitehall II study who were measured serially between 1991–1994 and 2012–2013. Baseline weight (non-obese or obese; body mass index (BMI) ≥30 kg/m(2)) and health status (healthy or unhealthy; two or more of hypertension, low high-density lipoprotein cholesterol (HDL-C), high triglycerides, high glucose, and high homeostatic model assessment of insulin resistance (HOMA-IR)) were defined. The relationships of baseline weight/health status with 20-year trajectories summarizing ~25,000 observations of systolic and diastolic blood pressures, HDL-C, triglycerides, glucose, and HOMA-IR were investigated using multilevel models. Relationships of baseline weight/health status with all-cause mortality up until July 2015 were investigated using Cox proportional hazards regression. RESULTS: Trajectories tended to be consistently worse for the MHO group compared to the healthy non-obese group (e.g., glucose by 0.21 (95% CI 0.09, 0.33; p < 0.001) mmol/L at 20-years of follow-up). Consequently, the MHO group had a greater risk of mortality (hazard ratio 2.11 (1.24, 3.58; p = 0.006)) when the referent group comprised a random sample of healthy non-obese individuals. This estimate, however, attenuated (1.34 (0.85, 2.13; p = 0.209)) when the referent group was matched to the MHO group on baseline risk factors. CONCLUSIONS: Worse baseline risk factors may explain any difference in mortality risk between obese and non-obese groups both labelled as healthy, further challenging the concept of MHO. |
format | Online Article Text |
id | pubmed-6268092 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-62680922019-02-14 Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study Johnson, William Bell, Joshua A. Robson, Ellie Norris, Tom Kivimäki, Mika Hamer, Mark Int J Obes (Lond) Article OBJECTIVE: To describe 20-year risk factor trajectories according to initial weight/health status and investigate the extent to which baseline differences explain greater mortality among metabolically healthy obese (MHO) individuals than healthy non-obese individuals. METHODS: The sample comprised 6529 participants in the Whitehall II study who were measured serially between 1991–1994 and 2012–2013. Baseline weight (non-obese or obese; body mass index (BMI) ≥30 kg/m(2)) and health status (healthy or unhealthy; two or more of hypertension, low high-density lipoprotein cholesterol (HDL-C), high triglycerides, high glucose, and high homeostatic model assessment of insulin resistance (HOMA-IR)) were defined. The relationships of baseline weight/health status with 20-year trajectories summarizing ~25,000 observations of systolic and diastolic blood pressures, HDL-C, triglycerides, glucose, and HOMA-IR were investigated using multilevel models. Relationships of baseline weight/health status with all-cause mortality up until July 2015 were investigated using Cox proportional hazards regression. RESULTS: Trajectories tended to be consistently worse for the MHO group compared to the healthy non-obese group (e.g., glucose by 0.21 (95% CI 0.09, 0.33; p < 0.001) mmol/L at 20-years of follow-up). Consequently, the MHO group had a greater risk of mortality (hazard ratio 2.11 (1.24, 3.58; p = 0.006)) when the referent group comprised a random sample of healthy non-obese individuals. This estimate, however, attenuated (1.34 (0.85, 2.13; p = 0.209)) when the referent group was matched to the MHO group on baseline risk factors. CONCLUSIONS: Worse baseline risk factors may explain any difference in mortality risk between obese and non-obese groups both labelled as healthy, further challenging the concept of MHO. Nature Publishing Group UK 2018-08-14 2019 /pmc/articles/PMC6268092/ /pubmed/30108269 http://dx.doi.org/10.1038/s41366-018-0192-0 Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Johnson, William Bell, Joshua A. Robson, Ellie Norris, Tom Kivimäki, Mika Hamer, Mark Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study |
title | Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study |
title_full | Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study |
title_fullStr | Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study |
title_full_unstemmed | Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study |
title_short | Do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? Whitehall II Study |
title_sort | do worse baseline risk factors explain the association of healthy obesity with increased mortality risk? whitehall ii study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6268092/ https://www.ncbi.nlm.nih.gov/pubmed/30108269 http://dx.doi.org/10.1038/s41366-018-0192-0 |
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